StatusThe thesis was presented on the 5 March, 2019
Approved by NCAA on the 19 April, 2019
Abstract– 0.89 Mb / in romanian
13.46 Mb /
The thesis is 144 pages long of the main text and consists of an introduction, 5 chapters and synthesis of the result, general conclusions, practical recommendations, 29 tables, 42 figures and 21 annexes. The bibliography includes 202 sources. Twenty papers were published based on the thesis topic, including 4 without coauthors.
Field of study. Medicine.
Purpose of the study. The evaluation of particularities of pregnancy, birth and post-partum, of psychovegetative status, adaptive behavior of pregnant adolescents charged with the development of an algorithm of behavior and prevention of obstetrical and psycho-emotional complications.
Objectives of the study. Assessment of the clinical-evolutionary features of pregnancy, birth and postpartum, with the evaluation of psychological, neuro-vegetative and of the personality status; study of adolescent pregnancy adaptation mechanism; serum assessment of free amino acids as markers of pregnancy complication and depressive changes; elaboration of the algorithm clinical protocol for the psycho-emotional preparation of adolescent pregnancies for the prevention of maternal and fetal complications.
Scientific novelty and originality. This study allowed the analysis of the medical-social and evolutionary features of pregnancy, delivery and post-partum period of adolescents and the determination of risk factors for the development of possible complications. The importance of gynecological age, along with the chronological one, was also appreciated and has been assessed as a risk factor for the development: IUGR of the fetus, premature birth, congenital anomalies and other complications. For the first time, changes in the psychological, neuro-vegetative status and adaptation mechanism of adolescents during the pre- and postpartum period were evaluated. Moreover, the metabolism of aromatic amino acids (tryptophan, tyrosine, phenylalanine) and folates (homocysteine, methionine) was evaluated as markers that reflect not only the manifestation of depression at adolescent pregnant women but also the complicated evolution of pregnancy. These markers can be recommended in prenatal screening and introduced into everyday using The scientifically problem resolved in thesis consists of the elucidation of medico-social, clinicevolution particularities of the pregnancy, birth and postpartum period at teenagers in the relation with the psychological changes and there neuro-vegetative status which contributed to elaboration of the algorithm and clinical protocol care of perinatal period in adolescents.
Theoretical importance of the thesis. Through the research carried out, based on the clinical, biochemical and statistical investigations, there have been determined some new visions in the particularities of the pregnancy, birth and postpartum period in adolescent pregnancies. A group of pregnant adolescent with a high risk for developing neuro-vegetative disorders was highlighted. Serum markers have been elucidated in the development not only of prenatal depression but also in the development of some complications during the pregnancy. Was created an algorithm of behavior and which prevents of obstetrical, psycho-emotional and neonatal complications Application value of the paper there have been determined the risk factors that led to the occurrence of adolescent pregnancy and perinatal complications. Is presented the necessity and importance of the psychoemotional preparation of pregnant adolescent, the importance of supplementing the prenatal examination with serum determination of aromatic (tryptophan, tyrosine, phenylalanine) and folates (homocysteine, methionine) amino acids for the prevention of complications in pregnancy and the development of depression. Based on the study, there was elaborated a clinical protocol will allow for optimization of the pregnancy, birth hand the postpartum period on national level.
Implementation of the scientific results: The results of the study were implemented in the curative, didactic and research work of the IMSP Mother and Child Institute, SUMP "Nicolae Testemitanu", IMSP Municipal Clinical Hospital nr. 1, IMSP Neurology and Neurosurgery Institute.